Cardiothoracic Division

  • Dr. Karen Singh in the cardiac OR

  • Adult cardiothoracic anesthesiology division, from left to right: John McNeil, MD, FASE, Susan Walters, MD, Mike Mazzeffi, MD,MPH,FASA, Bob Thiele, MD, Karen Singh, MD, FASE, Keith Littlewood, MD, FASA, FSSH, Amanda Kleiman, MD, Keegan Stombaugh, MD, Jessica Zvara, MD, Randy Blank, MD, PhD, Paul Gallo, MD. Missing from photo: Sachin Mehta, MD and Josh Roach, MD

  • Josh Roach, MD

  • Drs. Jessica Zvara, Robert Thiele, John McNeil, and Karen Singh

  • University of Virginia Anesthesiologists place a line.

    Dr. John McNeil, MD, Vascular Anesthesia Division Chief supervises central line placement in a cardiac surgery patient.

  • University of Virginia Dr. Keith Littlewood teaches a resident in the Cardiac Operating Room.

    Dr. Keith Littlewood, MD teaches a resident correct cardiac procedures.

  • University of Virginia Dr. Randal Blank, MD teaches and performs a Bronchoscopy on a patient.

    Dr. Randal Blank, MD, PhD, teaches Residents Dr. Kathryn Black, MD & Dr. Emmad Kabil, MD the finer points of a bronchoscopy.


Dr. Karen Singh speaking with Dr. Jessica Zvara outside of the OR.

Dr. Karen Singh speaking with Dr. Jessica Zvara outside of the OR.

The Cardiothoracic Anesthesiology Division at the University of Virginia (UVA) provides anesthesia and perioperative care for adult patients undergoing a variety of complex cardiac, thoracic and vascular surgical procedures. Our Division faculty is excited to optimize patient care to give our patients the best possible clinical experience.


Cardiac anesthesiologists routinely perform anesthesia for coronary artery bypass surgery, complex valvular heart disease, thoracic aortic surgery, ventricular assist device placement and heart transplantation. In addition, we care for patients undergoing transcatheter aortic valve replacement (TAVR) and other transcatheter valve procedures as part of the robust Heart Valve Program at UVA. Our Anesthesiology Perioperative Echocardiography Service performs and interprets all adult cardiac surgery transesophageal echocardiography (TEE) and point of care echocardiography in the operating room and in the recovery unit (see Clinical Programs).


Our thoracic anesthesiology team provides comprehensive perioperative care for a wide variety of thoracic procedures, including lung transplantation and surgery of the esophagus, stomach, lungs, mediastinum, and the thoracic spine. Thoracic procedures include open and minimally invasive procedures, including classical video assisted thoracoscopic surgery, as well as robotic surgeries.


Our vascular anesthesiology team administers anesthesia for patients undergoing complex vascular surgery with a patient-centered approach. We have successfully developed and implemented cardiac and thoracic enhanced recovery after surgery (ERAS) programs. We enhance patient care through collaboration among the cardiothoracic and the vascular surgery teams, as well as with nursing staff who are essential to our progress. Teamwork allows us to give our patients the best possible outcomes.

A Message from the Cardiac Anesthesia Division Chief

John McNeil, MD, MBA, Cardiac & Vascular Division Chief

John McNeil, MD, MBA, Cardiac Anesthesia Division Chief

We have a very talented group of Cardiothoracic Anesthesiologists here at UVA. Our members have wide-ranging interests and skills in education, research, and clinical care. Many members in our division have been the recipients of teaching awards. Research interests are varied and include coagulopathy, echocardiography, advanced monitoring, medical student and resident education, and thoracic anesthesia.

Most of our division members hold National Board of Echocardiography certification in Advanced Perioperative TEE. Our goal is to provide excellent resident education, and several in our division regularly teach cardiothoracic clinical skills in the simulation center and give formal lectures to prepare residents for their cardiac anesthesiology rotation. Many of us also teach transesophageal echocardiography and point-of-care ultrasound (POCUS) to residents through formal lectures as well as hands-on instruction in the simulation center and perioperative setting.


A Message from the Thoracic Division Chief

University of Virginia Randal S. Blank, M.D., PhD, Thoracic Anesthesia Division Chief

Randal Blank, MD, PhD, Thoracic Anesthesia Division Chief

Thoracic division faculty are exceptionally committed to high quality patient care, education of medical students and residents, and research efforts to improve and advance medical knowledge. Division faculty have extensive expertise in a diverse array of specialized care modalities, including thoracic epidural analgesia, bronchoscopy, advanced airway management techniques, fiberoptic guided placement of lung isolation devices, lung ultrasound, and transesophageal echocardiography.

We are a group of experienced perioperative physicians who are actively engaged in advancing the clinical practice of thoracic anesthesia, teaching the next generation of thoracic anesthesiologists and advancing knowledge through clinical and translational research. Division faculty are involved in education and teaching at the national level and are engaged in collaborative research projects with other leading investigators at home and abroad.


A Message from the Vascular Division Chief

Dr. Jessica Zvara

Jessica Zvara, MD, Vascular Anesthesia Division Chief

Dr. Jessica Zvara was named Division Chief in March 2024.  The vascular anesthesia experience at UVA is excellent. The new Aortic Center at UVA brings in many patients with complex aortic disease. With vascular surgery volumes increasing, residents have the opportunity to care for high acuity patients undergoing a variety of vascular procedures, ranging from limb salvage, to dialysis access, to bypass surgeries, to multi-stage hybrid aortic repairs.

Residents are supervised by faculty from many divisions, with dedicated teaching of classic vascular anesthesia principles (preoperative evaluation, the physiology of cross-clamping, spinal drains, coagulation) during high-risk cases. There is an opportunity to hone point-of-care ultrasound (POCUS) technique and non-invasive continuous blood pressure monitoring familiarity during less demanding surgeries. Our division works closely with our vascular surgery colleagues and the rest of the perioperative team to provide the best care possible to all patients undergoing vascular procedures at UVA.

Our Division